Channer K S, Bell J, Virjee J P
Br Heart J. 1984 Aug;52(2):223-7. doi: 10.1136/hrt.52.2.223.
The oesophageal transit time of barium sulphate capsules was measured using X ray fluoroscopy in 20 patients with mitral valve disease and 12 control patients in the erect and supine positions when swallowed with both 15 ml and 60 ml of water. An erect barium swallow was performed, and from a lateral radiograph the area of indentation of the oesophagus caused by the cardiac impression was measured. Left atrial diameter was derived from M mode echocardiography. In 19 patients with mitral valve disease one or more capsules remained in the oesophagus for five minutes and disintegrated there, whereas this occurred in only six control patients. Capsule transit time was significantly slower in the study patients than in the control patients in the supine position with 15 ml water. There was a significant correlation between the area of indentation and mean capsule transit time and supine 15 ml transit time. The area of indentation closely correlated with the left atrial diameter. When capsules were delayed in the oesophagus, this occurred mainly at the level of the left atrial impression in the study patients and at the lower oesophageal sphincter in the control patients. Patients with mitral valve disease are more likely than control patients to have delayed oesophageal transit of capsules because of the anatomical deformity caused by enlargement of the left atrium.
对20例二尖瓣疾病患者和12例对照患者进行研究，在站立位和仰卧位分别用15毫升和60毫升水冲服硫酸钡胶囊后，利用X线透视测量其食管通过时间。进行立位吞钡检查，从侧位X线片测量心脏压迹所致食管压迹面积。通过M型超声心动图测量左心房直径。19例二尖瓣疾病患者中有1例或更多胶囊在食管内停留5分钟并在该处崩解，而对照患者中只有6例出现这种情况。在仰卧位用15毫升水冲服时，研究组患者的胶囊通过时间显著慢于对照组患者。压迹面积与平均胶囊通过时间及仰卧位15毫升水冲服时的通过时间之间存在显著相关性。压迹面积与左心房直径密切相关。胶囊在食管内延迟时，研究组患者主要发生在左心房压迹水平，而对照组患者主要发生在食管下括约肌水平。二尖瓣疾病患者比对照患者更有可能因左心房增大导致的解剖学畸形而出现胶囊食管通过延迟。
